Provider Demographics
NPI:1164686390
Name:SEDLAK, MANDI J (CMF)
Entity Type:Individual
Prefix:
First Name:MANDI
Middle Name:J
Last Name:SEDLAK
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3811 29TH AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-1280
Mailing Address - Country:US
Mailing Address - Phone:308-238-2230
Mailing Address - Fax:308-238-2229
Practice Address - Street 1:3811 29TH AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-1280
Practice Address - Country:US
Practice Address - Phone:308-238-2230
Practice Address - Fax:308-238-2229
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter